Posts Tagged ‘education’

I have been teaching for the Section on Women’s Health for years, but what I witnessed in May 2017 as one of four instructors leading SOWH’s first Tokyo courses is the most amazing experience yet.

Joined by Director of Education Lori Mize, Mary McVearry Austin and Susan Giglio, I embarked on a historic trip to Japan to spend six days teaching 40 Japanese physical therapists about pelvic health and obstetrics physical therapy.

Three men participated in our sold-out courses, and few attendees spoke English. At least one was pregnant. We had an obstetrician and a few professors in the audience. Participants arrived by plane or train from all over the country, taking a rare week’s vacation to attend and often paying all registration fees and travel expenses out of pocket.

Attendees took lecture notes while kneeling on floor mats with course manuals open on exam tables. They listened intently to lectures on pelvic anatomy, incontinence and hormonal changes in pregnancy through headsets that translated their English-speaking “sensei” in real time. They were unfailingly punctual and inquisitive. Why was this knowledge so important to them?

Japanese are very polite, private people. Discussion of vaginas and incontinence is considered impolite. Many women and men have pelvic health problems in Japan, but they don’t seek help. Frankly, I wondered if this group really understood what its members had signed up for–labs that involved disrobing, mirrors, lube, gloved fingers and raw illustrations of vaginas and vulvas.

To respect cultural norms around privacy, the host placed black portable screens around exam tables. Unfortunately, the screens inhibited learning by blocking the overhead screen showing illustrations of key external structures they were trying to locate, and lab assistants couldn’t maneuver around the screens to help them. We instructors regrouped–what now?

The instructor, Lori Mize, appealed to her audience to loosen cultural norms in favor of professionalism and their need to learn to be comfortable with personal exams, so patients could relax. There was no pressure; if attendees still wanted the screens, they could use them.

After that discussion, something changed. These shy, polite Japanese women voted to dump the physical barriers to learning. They stacked the screens to block entrance to the room and separated the men but broke down the barriers between each other. Then they undressed and examined urethras and vaginas with enthusiasm and professionalism. Changing partners, they consulted with each other and us, practicing until they could identify everything and bonding over the experience.

We witnessed a transformation, the birth of a Japanese women’s health PT group of women and men dedicated to improving pelvic health care in Japan. Currently, they are only loosely organized via a Facebook page, but they have each other, and they definitely have us. I’m confident they will continue to grow and become more vocal about how PTs can treat impolite problems such as incontinence and pelvic pain or how PTs can prevent maternal birth-related injuries.

We witnessed—sparked, really­–the evolution of Japanese pioneers in pelvic health PT! Clearly, there are no boundaries in the need to improve women’s and men’s pelvic and abdominal health. The same problems exist worldwide.

That’s why SOWH belongs in Japan, Chile or anywhere else we can help start a pelvic health revolution. As I ponder how to summarize the course experience, I believe Margaret Mead said it best: “Never underestimate the power of a small group of committed people to change the world. In fact, it’s the only thing that ever has.”

“Jake, the first ever Male Pelvic Floor course is coming here in Seattle. If you take it, you could see the men and reduce my three-month wait for new male and female pelvic floor patients.” This was the prompt from my dear friend Tina Allen, PT, in 2008—and that is the short answer to “How did you get into treating the pelvic floor?”

I took that course, and my fear of both performing and receiving a rectal examination was quickly replaced by recognition of how necessary well-trained therapists are in the United States.

I was one of only two male course attendees. Nearly all of the female attendees were there because they had been involved in women’s health and had begun having men referred to them. Physicians didn’t know where else to send male patients with pelvic floor dysfunction.

I then took the second of a three-course women’s health series and was the sole male. When I walked into the classroom the first morning, I felt an icy chill spread through the room. All of the women’s heads turned toward me, and I suddenly felt out of place and unwelcome. Fortunately, the co-instructors began with introductions, and when it was my turn, one of them quickly announced how lucky the class was to have me, both to have a male perspective and a prostate to palpate if they could have me as a lab partner at some point during the weekend. The ice melted, and I felt the room relax. The rest of the course went swimmingly.

Seattle has many talented pelvic floor therapists, but I was happy to be available to men who really wanted a male therapist.

In 2014, I stepped away from the clinic for one year after the birth of my first son. I then hoped to continue my primary role as a stay-at-home dad but wanted to maintain my license and resume helping men who preferred a male therapist. My boss let me return half a day each week just to see male pelvic floor patients, but while this arrangement worked well, our local, family-owned company was purchased by a large national organization. Simultaneously, I was approached by Holly Tanner to join her new cash-practice pelvic floor clinic. I couldn’t say no; it allowed even more flexibility for me to continue as primary caregiver to my children.

My gender still raises the occasional eyebrows when I explain my specialty to other PTs or students, but that is changing. While lab assisting at male pelvic floor courses during the past two years, I’ve been encouraged to see four to six male PTs attending each one.

We need them. The profession, scope and scale of our patients are growing, and the many waitlists at pelvic floor facilities are often long. Patients—male, female, transgender or otherwise identifying—are hearing about what we can do for them. Let’s make sure all education for pelvic health professionals and students is as welcoming and inclusive as possible.

AUTHOR: Jake Bartholomy, PT, DPT, is a pelvic health therapist in Seattle, Wash. He can be reached at [email protected].

Something caught me by surprise when I began working with students full-time in the academic world. I find very interesting (and awesome) how they have this inner desire to know just as much about how to be an adult, professional, wife, or mom as they want to know about classroom physical therapy content.

I also feel a figurative smack in the forehead and imagine hearing, “Duh!” really loud. People were designed for relationships and community. Students need this personal relationship not only with their classmates, but also with instructors introducing them to the fine profession we call physical therapy.

Our students are watching us in the classroom and elsewhere in our lives. (Cue Sting song: “I’ll Be Watching You.”) They seek role models, but we often leave our lives at home and our work at work.

When I was a student on clinical rotations, I had a rather cheeky clinical instructor in an acute care setting once tell me that I revealed too much information to my patients. I disagreed! I would have seen her point if I had revealed something inappropriate like my address, detailed childbirth experiences, etc., but I just talked to them. I tried to find commonalities between where we were from, our children, interests, anything but more medical jabbering.

Interpersonal relationships matter, even those kept at a protected distance between patient and therapist. In our profession we more easily acknowledge the healing power of relationships with our patients. We even cite research that points to the patient-professional relationship being as important as the latter’s skill and intervention.

Yet throughout PT curriculum, emphasizing (appropriate) interpersonal relationships and mentorships with students is not our strong suit. We pride ourselves in our “biopsychosocial” approach to patient care but often forget to apply that same concept to our students.

What causes this invisible barrier of access? (Cue MC Hammer song: “Can’t Touch This.”) Sure, risks must be managed—we’re in a litigious society–but I think it may be something more. I think we’re holding back from our students because we fear our vulnerability, exposure, and failure. We subscribe to a never-let-them-see-you-bleed mentality, when in reality, they would learn just as much, if not more, if they did see us bleed … and then recover!

My literature search about the effect of relationships and mentorship outcomes between students and instructors has come up empty. I’m sure this is primarily due to the many variables that contribute to the research question and the difficulty of identifying specific enough questions. However, I plan to study this, to find out how we can transform students into better, more amazing, passionate, and fulfilled physical therapists. We must learn how to identify what may be a missing element in our teaching environments.

Students are no different from patients. I believe they—and their learning–thrive better with trusting relationships. And when personal relationships and mentorships occur, they get to learn how to be adults, good partners, parents, professionals, servants, and so on. Sometimes, that gets messy, but I think they benefit from that, too.

Why should they have to wait until they graduate and have a job to begin that relationship and mentoring process? Let’s all start advocating for a more “whole-person” approach during a student’s most formidable time. (Cue climax of various superhero theme songs.)

McLean, VA: The Section on Women’s Health, a professional association of nearly 3,000 physical therapists and students who specialize in pelvic and abdominal health, has honored seven outstanding volunteers with its inaugural education awards during the 2017 SOWH Annual Business Meeting.

SOWH leaders presented the awards February 17 during the American Physical Therapy Association’s Combined Sections Meeting in San Antonio, Texas. SOWH is an independent organization affiliated with APTA.

“High-quality, evidence-based education has been core to the Section on Women’s Health mission since our founding 40 years ago,” says Director of Education Lora Ann Mize, PT, DPT, WCS. “While we have many wonderful volunteers involved in providing education across the country, these award winners stand out for particular achievements in the past year or for longtime high-impact service.”

“Jenn has been fantastic! She is so smart and fun, and she is always behind the scenes making sure all is covered, so courses and especially labs run smoothly. I always feel confident that there are no worries when she is at a course. Jenn is outstanding, warm, friendly, and is dedicated to optimal learning for course participants.”

“Gail has always been willing to host whatever courses we have needed at the SOWH, even if that was not a course that her staff required. She invests so much of her personal time and energy into the Section. We are grateful to have Memorial Hermann as one of our premier partner sites, and we couldn’t do it without Gail.”

Outstanding Education Volunteer of the Year 1: Karen Snowden

“Karen has volunteered for the Section in so many ways, from chairing the CAPP-OB Case Review Committee to being a committee member and assistant chair on the CAPP-OB committee. She also has been a committee lab assistant for the SOWH courses. Karen is incredibly dedicated to the profession, our association, and to excellence!”

Outstanding Education Volunteer of the Year 2: Karen Litos

“Karen has volunteered for the Section in so many ways. Of particular note is that she edited our course and lab manuals, and has been a member of the CAPP-OB Committee.”

Outstanding Instructor for CAPP-OB: Darla Cathcart

“Darla is an excellent instructor. She knows the material and is wonderful at keeping people engaged. She is described as a dynamic, effective teacher with a true passion for pelvic health. She consistently scores extremely high in participant ratings for all courses she teaches and has set a great example for the CAPP-OB committee and instructors, developing procedures and practices that guide practice today.”

Outstanding Instructor for CAPP-Pelvic: MJ Strauhal

“MJ is an excellent instructor who invests herself in remaining current in the pelvic health literature, makes herself approachable to participants, and has a way of keeping the interest of everyone in the room. I have always enjoyed hearing MJ teach. She is extremely knowledgeable and effective. Her passion for pelvic health and course participants learning is so amazing! And if there ever was an article written regarding pelvic health, MJ not only knows its contents, authors, and date published, but she has a copy of it in her suitcase that she brings with her to every course. MJ serves not only as a mentor for pelvic instructors, but also for many pelvic health practitioners. Our field would not be where it is today without MJ.”

Years of Service Award: Rebecca Stephenson

“Rebecca has been serving in some capacity within education for as long as I have been around, and I am certain even longer. Rebecca came onto the CAPP-OB Committee in 2009. She has developed modules and course materials, lab assisted, instructed, mentored new lab assistants and instructors, done course hosting, and now is leading our international endeavors! Rebecca has done all this while also representing the SOWH as an officer (most recently, president) of the International Organization of Physical Therapists in Women’s Health.”

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Celebrating its 40thanniversary, Section on Women’s Health-American Physical Therapy Association (SOWH) is a professional membership association of nearly 3,000 physical therapists treating patients across the life span and around the globe. Members provide the latest evidence-based physical therapy services to everyone, including LGBTQ populations, young athletes, childbearing women, peri-menopausal mothers, and men with pelvic health complications. In addition to providing top-quality continuing education, the Section provides networking opportunities, access to peer-reviewed research, inclusion in a PT Locator directory, and lab training. Learn more at www.womenshealthapta.org.

2016 APTA Minority Scholarship winner Kimmi Edwards, DPT, calls for expanded support of minority PT students to diversify the profession.

Do you have strong feelings about whether minorities are well represented or recruited into the physical therapy (PT) profession?

Physical therapy began as a predominantly woman-dominated profession. Now men are entering at a faster rate than other minority populations in our midst.

However, this historically predominantly white profession has seen only a minute increase of minorities now accepting this profession as a career path.

“Why?” I wondered. When you go into a black society and ask the question, “What do you want to be when you grow up?” The answer is often a lawyer, engineer, doctor, or professional athlete.

Rarely do you hear “an occupational therapist,” “a physical therapist,” or even “a speech therapist.” Society at large is still uneducated about our profession or has any idea how successful, rewarding, and happy our careers are!

Do we as professionals and future professionals do a great job of reaching out to communities and advocating for this profession? What makes these boys and girls want to become a lawyer, doctor, or professional athlete? Is it because they don’t know the PT profession exists?

Possibly. There is certainly a huge gap in student applicants for physical therapy programs when it comes to minorities, which led to my decision to survey Alabama PT schools about minority attendance. I am not from Alabama, but I recently graduated with my Doctorate of Physical Therapy (DPT) from Alabama State University.

As of May 10, 2016, there are four DPT schools in Alabama with 404 physical therapy students, 56 being minorities (13.86%). Taking these numbers into consideration, I question whether other states have similar statistics? What can be done to improve them? More importantly, what can I do about that change?

Thankfully, the profession does offer some opportunities such as American Physical Therapy Association Minority Scholarships that support the success of minorities. Scholarships of this nature can help not only attract future diverse PT students into our field for the extensive good we do for our patients, but also communicate that physical therapy has a welcoming professional culture for minorities.

Current minority PTs, in particular, should continue their tremendous encouragement and recruitment of other minorities. If boys and girls in underserved communities can see and hear firsthand about our profession and its success from minorities they can identify with, more progress can be made toward attracting them to PT career options.

I want to make minority scholarships better known to students by referring them to learn the latest on APTA’s Honors and Awards web section. Students can submit applications or be nominated—as can professors–every September, but PT and physical therapy assistant students must in their final year of PT education.

In 2016, eight PT students and four PTAs students in the United States won scholarships supported by the Minority Scholarship Fund, to which the Section on Women’s Health-APTA recently donated $500. Anyone else interested in donating to the Minority Scholarship Award may contact Johnette Meadows, [email protected].

Together, we all can change the physical therapy profession, particularly in men’s and women’s health, to better reflect the diversity of the patients we serve.

Author: Kimmi Edwards, DPT, is a 2016 APTA Minority Scholarship winner and Section member. She can be reached at

[email protected].Note: The statistics above apply only to PT, not PTA, programs in Alabama state universities.

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Through advocacy and scholarships, SOWH is trying to reduce debt burden for PT students in women’s and men’s health.

By Alicia Jeffrey

As the class of 2016 races to the finish line, excitedly going through graduation and beginning our first jobs as physical therapists, many of us feel the shadow of debt looming close behind.

The “real world” is approaching, and it’s becoming difficult to shake the strange feeling of impending doom that accompanies the thought of student loans. This may sound like gross hyperbole, but more than a few studies link financial stress to poor mental and physical health.

The cost of attending physical therapy school has been skyrocketing, although this trend is not unique. Tuition for graduate and professional programs for all fields has

been rising, too. However, tuition for physical therapy programs has more than tripled in the last 15 years—that should raise concern within the profession.

Students are frequently reminded we’re lucky to be going into a profession with such a stable job outlook, but the debt-to-income ratio for newly graduated physical therapists continues to climb to a point that many of us feel suffocated.

Statistics show that we have reason to feel that way. In the last 15 years, median salaries for physical therapists have increased only 2.6% annually–roughly enough to keep up with inflation—while private school costs have increased 4.6% per year, and public school costs have risen 7.9% per year.

Fortunately, I have no loans from my undergraduate degree, but between three years of DPT tuition and living expenses, I have accumulated over $120,000 in student debt.

Ironically, I have that scary debt total despite choosing to attend the “cheap” in-state school and despite my burning desire as a college senior to experience a further-afield adventure. It’s frightening that even with this financial foresight, my monthly loan payments will easily exceed what I will pay in rent and utilities on a house after graduation.

New graduates are often forced into an impossible situation in which we cannot find the money to make important life purchases. Our stress level is through the roof as we carefully try to avoid any financial mishaps that will throw off our meticulous budgeting. And to make matters worse, we are chastised by the media, which notes our generation is not adequately contributing to the economy by not buying houses and new cars!

In addition, approximately one-third of my graduating class is engaged and is trying to save money for a wedding (on top of loan payments and the typical acquired expenses associated with graduation). Many young professionals are opting for prolonged engagements to save up for a modest wedding. What will happen when these young couples begin having children?

The most common response we receive when expressing our concerns is, “Well, you knew what you were getting into.”

Did we really? As an early 20-something, I was most concerned with finding my passion and making sure that I was going into a rewarding field. Physical therapy felt like the right choice. I was overly optimistic about how quickly I could pay off my loans, and after all, with no significant scholarships to speak of, how hard could it be if everyone else in PT school was going through the same thing?

The problem is that no one has wanted to admit they are struggling with their loan burdens.

We can do better. Physical therapy is one of the most rewarding and fundamental health professions. Changes must be made to help alleviate the cost for students and new graduates in order to keep attracting bright talent into the field of men’s and women‘s health. We cannot continue to prey on the altruistic individuals often drawn to the physical therapy profession.

Are there alternative financial aid programs that could be developed? Perhaps expanded access to assistantships and scholarships in lieu of loans? Professional burnout will continue to worsen if new grads believe they need to take on multiple jobs just to make ends meet.

Put simply: Our profession must take better care of its members–as students, as early-career professionals, and as full-time physical therapists.